Impact of Stress on Brain Architecture and Resilience Transcript Start [Music] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. [Music face out] Fade to black. Dr. Judy Cameron: Okay. I am really happy to be here today. They are right, I often talk to audiences who are concerned about children that are growing up in poverty and have a number of different life stresses, but we also have developed these tools to talk to broad audiences that have all sorts of different kinds of things that they deal with. And you'll see that what I'm going to talk about today is how life experiences actually play a very important role in shaping brain development. And many people are surprised to hear that. They think, well, you're born and your brain just develops. It must be that the genes control brain development. And I like to use my hands as models. I think you're going to like it too and you'll understand this. So at the time you're born you have all the brain cells that you're ever going to have, almost all. You get a couple extra, but very few. So you have almost all the brain cells. Let's stay your brain cells look like this, okay? My hands are brain cells. You have billions of brain cells, so you have to imagine me with billions of hands, right? [ Laughter ]. Okay. They're here and they're not really connected to each other. Different parts of the brain develop at different times. And when a part of the brain develops, the cells automatically reach out extensions and they connect to each other so there's tons of connections that are made. And then surprisingly ‑‑ and it took neuroscientists a long time to understand this, not all the connections stay. In fact, only some of the connections stay. A lot of the connections get pruned away and you're left with just some connections. What determines which connections stay and which connections get pruned? That is where experiences come in. Connections that get used a lot are more likely to stay. Connections that don't get used very much will get pruned away. So by the time you're your age, each one of you ‑‑ [ Laughter ] ‑‑ has a very different brain from the other one of you. There's no two people in this room that have brains that are constructed the same way. For each of you your experiences determine which circuits get used, and those are the circuits that you permanently have. So we're going to spend some time talking about that over the next hour. I'm going to use a lot of tools to try to show you this the real beauty of how this conference is designed is that we're going to have a panel discussion this afternoon, and I was in a phone call about a week, week and a half ago with all the members of the panel and they are experts on DeafBlindness. I'm not an expert on DeafBlindness. I've been trying to learn more about it, knowing that I would get to come and talk to you, but they will interpret the general information I give you and you will be able to make use of it because you're going to have experts here that help you think about it? And for me, I think that's going to be really exciting. I'm looking forward to learning a lot today. Okay. So let's get started. So we think of lifelong health and the foundation of lifelong health and lifelong abilities. So health is one thing, being able to do things, abilities are another. And we think the foundation of both of these things develops in childhood. And if you ask people on the street, they think, well, most of brain development must happen really early. So I have news for you. Brain development starts before the baby's important, so that's early, but it doesn't finish developing. You don't finish getting brain pathways until a child is about 25, 26 years of age. That's a long time. You have a long period of time of brain development. The key to thinking about this is that the brain is not just one thing. We think oh, the brain looks all the same. It's just one thing. But it's not. It's like a lot of little brains all stuck together. Each brain area develops at its own rate and it develops at very different times. So in a few minutes I will use some of these poster tools to show you how that works. We're going to cover four concepts, but don't worry this talk is not going to go on and on and on. We will try to do a good job of covering these four concepts. First, we want to show you the brain architecture is established early in life and it underpins life‑long learning, behavior and health. Then secondly, and I think this was emphasized in the introduction, is really important, what's amazing to me is I'm a neuroscientist and I'm up here telling you one of the most important things for adequate brain development is stable, caring relationships. If there's anything that matters, that matters. And neuroscientists didn't used to think about this as all. But it's really important. We're going to spend a little bit of time talking about toxic stress, adverse experiences in the early years of life and how it can derail healthy development, because everybody can experience stress. We each have the things we're dealing with, but on top of that, each of us experiences stress. At a number of points in our life. Starting to understand how does stress interact with other things is important. And then we're going to finish, I think, on a positive note. Talking about resilience. How can resilience be built through "Serve and return" relationships. Those close, personal relationships. Improving self‑regulation, executive functions, and giving children a sense of mastery. So, I think, there's no parent in the world that doesn't care to make their child more resilience, more able to deal with what they're going to face. I'm sure all of you feel that way. So we're going to finish with that because it's a very positive note to end on. I'm going to start with ‑‑ with a material and I'll use these throughout the talk. The National Scientific Council and the Harvard center on the developing child, you may be wondering what's the difference? Well, you have a center at Harvard, but Harvard just has scientists that are right there at Harvard. They realize that there are experts all over the world that they would like to draw on and have connected to and have ‑‑ think about these issues. So the scientific council meets on a regular basis and we've been meeting since the very beginning of the center and we're the people who make all of the materials you see when you go to the center website. So there's a number of publications, there's some one‑page briefs, two of them got put in your folder, but there are a lot of them. There are many videos. I'm going to show you four videos today and I ‑‑ I played a role in making those videos. So the members of the council are the people who bring their expertise to the center and help develop outreach tools. A couple of years ago, we realized that we were doing pretty good job providing outreach to legislators, to ‑‑ to professionals, but we hadn't really developed any tools for just talking to regular people. That don't want to read scientific information. We sat around the table, we thought, "Well, everybody wants to read scientific information." [ Laughter ]. No? And a number of people told us, no, no, you guys don't have that right. It turns out, a lot of people want to learn things but they don't want to learn it by analogging through dense scientific writing. And the council considered making learning, educational tools that would be more widely usable. But decided we couldn't take that on. Working for kids, building skills, is a program that I've developed at the University of Pittsburgh. But just like the council, it's very tightly connected to the Harvard Center and what working for kids does is it ‑‑ is an educational way of learning this information. But you don't have to read a lot. It uses fun, hands‑on tools. And I think that out on the tables outside, there are a number of brochures that look like this. That tell you about this program. If you kind of thumb through, you'll see pictures of the materials. And I'll use the materials today to get certain points across. So this first slide that you're looking at is a working for kids material that we use to convince people that experiences really matter with brain development. I realize that I'm in a meeting talking about deafness and blindness, but I'm going to talk about scientific fact and this was one of the very first scientific findings that led people to realize experiences really matter. So I'm talking to you about it, knowing that a lot of you are not going to be able to relate to the hearing issue. But so that you understand where did this science come from. How did we learn what we're going to be talking about today? The same principle is true for absolutely everything we learn. So you might think, well, we go to school, we learn about history, we learn about English, we learn about math, science. But ‑‑ but everything a person does is learn. Nothing develops without learning. So ‑‑ how do you express happiness? How do you express sadness? How do you interpret people? I'm looking out at the audience and people kind of have their eyebrows down, they're looking at me, I think they're seriously thinking about what I'm saying. That makes me happy. [ Laughter ]. Of course, I could interpret that as hmmmm, I don't know what you're talking about, that wouldn't make me happy. But I choose to make myself happy. [ Laughter ]. All of the things that you're able to do have been learned. All of them are influenced by how much experience you've had with them. So let's walk through this example. What you're looking at is the size of a child's vocabulary that is ‑‑ let me see if I can use this ‑‑ is that showing up? Yes. Okay. The size of a children's vocabulary is shown here. Most children start talking at about 12 months of age. And if we look over at the first year that they're talking, between one years old and two years old, we see that some children develop a lot of ability to talk. They have a huge vocabulary. Let's look at this little fellow up here. His mom is a hairdresser. Now, I don't know about your hairdresser, my hairdresser talks always. [ Laughter ]. The whole time I'm getting my hair cut, he's talking, talking, talking. I think I'm the only neuroscientist that ‑‑ that he has. He doesn't see neuroscientists all the time. It's not like he knows what to talk about to me. But he talks! And this mom, being a hairdresser, started talking to her baby the minute the baby was born. Her friends made fun of her because she said the baby can't understand or talk back. She said, well, I don't care. I'm so excited to see her. I'm just going to talk to her. And this baby was exposed to a huge amount of vocabulary. As a result, he's on a trajectory where he's learning a lot of words. By the time he's 24 months old, two years of age, he knows about 600 words. Think about this little boy. He's on a different trajectory. He actually lives in the same neighborhood. He lives two houses away. And his mom has slightly more education. She's a dental hygienist. Now, I don't know about you. When I go to the dentist I have my mouth wide open. Even if somebody talks to me, I can't answer. And she's not the most talkative person. It works well for her for what she does. And she thinks "I'll talk to my son when he gets to be old enough to talk back to me." So this child is exposed to much less talking. And by the time he's two years old, he'll have 150 to 200 words in his vocabulary. Now, you might think that that doesn't matter. There are only ‑‑ they are only two years old. There's a lot of time to develop. But these are trajectory lines. And they will continue. So that by the time this child gets to kindergarten, he will know many fewer words, and he will be much less comfortable talking. Than the other child. Now, think to yourself, do you think it's going to make a difference on how he does when he goes to school? If he's talkative versus not talkative? Makes a big difference. If you're talkative, it's easier to make friends, right? Yeah. And you can make friends if you're not talkative, but lots of times other children will initiate the friend making. So it's easier to make friends if you're talkative. It is easier to get the attention of the teacher. Of course, sometimes you are talking when you shouldn't be talking [ Laughter ] and you get the attention of the teacher, all right. But you also can raise your hand. You also can answer questions. So these early experiences set up the brain to develop different pathways and speaking, as we'll learn in a few minutes, is something that's developing pathways during the first five to seven years of life. And children who have a lot of experience speaking, early on, are always going to be at an advantage from a speaking perspective. Now, I told you, remember, you already are semi neuroscientists, right? You already know that these are neurons in my brain and brain cells, and now we'll look at a picture of this. What you're looking at is how the brain develops. So at birth, in many, many brain areas, there are the cells that are going to be there all your life, but they're not very connected. If that brain area is undergoing development early, by three years of age, there will be tons of connections. There's no new cells, just lots of connections. And then at 14, there are fewer connections. Now, I have some people say: "Does that mean my 14‑year‑old isn't as smart as my three‑year‑old?" I have teenagers, sometimes I think that may be the case. [ Laughter ]. Nevertheless, that's not what this means. That's the wrong interpretation. What it means is that a lot of connections were pruned and there are some really sturdy connections. Those work better and faster and more efficiently and a child with sturdy connections in that area is able to do that activity very efficiently. So every part of the brain develops with this process, that different part ‑‑ but different parts of the brain develop at different times. I told you that prenatally the brain starts developing, the areas that control vision, hearing, taste, smell, the sensory pathways are making connections before the baby's born. But then the first year of life is really important. The downward swing here means that pruning is happening. So experiences that happen in the first year of life are really important for sensory functions. Language is different. Language areas start developing, shown by the blue line prenatally, but a lot of connections are being made within the first year of life and then pruning occurs during childhood. So until about five, seven, eight years of life. So experiences have a big influence on those pathways in early childhood. Now, the really good news, when you are going to I think by the end of the hour feel this is really good news, is that the front part of the brain, right behind your forehead, the prefrontal cortex is very late to develop. It's shown by the red line and it's making connections for the first 10 to 12 years of life. It's still slowly making connections. And then the pruning process goes on until about age 25. So experiences, all through the teenaged years, into the 20s, are shaping the development of this part of the brain. What is this part of the ‑‑ what does this part of the brain do? Well, it controls some really important things. It connects back to every other part of the brain. It controls planning, problem‑solving, complex reasoning. Trying to keep multiple things in mind at once. And make a decision about what you should be doing. That's complex reasoning. We all do it all the time. We were still developing pathways for that up until about 25 years of age. Now, my children don't like this story, but I like to tell it. Typical parent. So I have a child that's 28 years old. She went to college when she was 18. So she's been gone for 10 years. And she comes home three or four times a year, and every single time she comes home, she forgets her keys. Sound familiar? Yeah. Every time she comes home. And I make a copy of the house key, I hand it to her. She never remembers to give it back to me. And the next time she comes home she doesn't bring it and I make her another key. Somewhere she's ‑‑ she's in Colorado right now. She has a huge stack of house keys. [ Laughter ]. This last Christmas, just a couple of months ago, right as she was leaving, she turned to me and she said, mom, I'm going to give you this key back because you might need it if I ever forget to bring my key again. [ Laughter ]. I'm standing there thinking, if you ever forget!!?? ? [ Laughter ]. What are you talking about? And her father is standing right there and he goes, oh, she's growing up. [ Laughter ]. What do I say? Oh my gosh! Her prefrontal cortex has developed! [ Laughter ]. Now, she has a 24‑year‑old brother ‑‑ oh, he isn't even close, not close. [ Laughter ]. And then there's the 19‑year‑old. Now, the 19‑year‑old's interesting. She doesn't even think you need a key to get into the house. [ Laughter ]. She has a cell phone. So when she comes home, she just calls mom or dad. Hey, where are you? I need to be let in. [ Laughter ]. So I tell you this story so that it sticks in your mind. You really are forming brain circuits in your late teens and 20s. The experiences that an individual has at that time are still going to play an important role. From the side of resilience, this really matters. A lot of you are working with kids that have special circumstances and development of some skills is slower than it might be for average kids that don't have the same impediments to deal with. And you're worried and you're thinking, oh, brain development happens early. But the good news is brain development continues until about 25, and you have a long time in which to make connections back to other parts of the brain. So we're going to watch a brief movie that the national council developed, and then we're going to use one of these posters to teach you a little bit more about brain development. [Video playing]. A child's experiences during the earliest years of life have a lasting impact on the architecture of the developing brain. Genes provide the basic blueprint, but experiences shape the process that determines whether a child's brain will provide a strong or weak foundation for all future learning, behavior and health. During this important period of brain development, billions of brain cells called neurons send electrical signals to communicate with each other. These connections form circuits that become the basic foundation of brain architecture. Circuits and connections proceed live rate at a rapid pace and are reinforced through a repeated use. Our experiences and environment dictate which circuits and connections get more use. Connections that are used more grow stronger and more permanent. Meanwhile connections that are used less fade away through the normal process called pruning. Well used circuits create lightning past pathways for neural signals to travel across regions of the brain. Simple circuits form first, providing the foundation for more complex circuits to build on later. Through this process, neurons form strong circuits and connections for emotions, motor skills, behavioral control, logic, language and memory during the early critical period of development. With repeated use, these circuits become more efficient and connect to other areas of the brain more rapidly. While they originate in specific areas of the brain, the circuits are interconnected. You can't have one type of skill without the others to support it. Like building a house, everything is connected, and what comes first forms a foundation for all that comes later. Cameron: Okay. So you're starting to get a good sense about brain development. We're going to use another tool that Working for Kids has developed to talk about brain development. And why did we develop yet another way of doing this? The reason for doing that is not everybody likes to read. The council started to make movies and videos that would explain the concepts, but turns out that you have to have access to those videos, and in many communities that we're working in now, people don't have access to TVs or movies or computers. They do have their phones, and we're starting to make phone friendly versions of some of these. Nevertheless, we decided that it would be really useful to have some hands on learning materials that could be taken anywhere. So you might wonder how exactly do I get a six‑foot brain anywhere with me? Well, it just rolls right up and fits in a little carry bag, and I can take it anywhere. And we do that. And it's a much funner learning process. So I'm going to walk you through this. I've tried to turn this so you can see what I'm doing, but I'll explain what I'm doing. Okay. So remember I told you that sensory pathways, things like hearing, seeing, taste, smell, develop early. They're one of the first things to develop in the brain. So I have the picture of a child's eyes here and I'm going to just stick that up in the part of the brain that controls vision. It turns out that vision takes this whole back part of the brain. And people are surprised by that. They think well, the eyes are in the front of your head. Why is the part that controls vision way back there? I don't know the answer to that. [ Laughter ]. But these eyes send optic nerves back, the vision signals come here, and then this part of the brain sends information to other parts of the brain. What happens right when a child is born? Well, right away ‑‑ what do I have here? I have the picture of a child looking a little grumpy and starting to fuss. Children cry. They cry immediately. Okay. The part of the brain that controls emotions, both producing emotions and recognizing emotions, is right in the middle of the brain, okay? It's here. It's starting to make connections in birth and over the first several years of life, and then it has a longer period of development than the visual system. This developed prenatally and is being pruned over the first year, so it's a very sharp peak. This is a broader peak. It's making connections throughout early childhood and it's still pruning up until adolescence, so pathways are being made for emotion recognition and expressing emotions. The pathways for talking are right above that and you're making pathways for being able to speak and vocalize, starting from birth, and for the first few years of life, and then pruning occurs. Now obviously you talk all your life, but you're using the pathways you built early. You're not making new pathways. This part of the brain right at the top is an area that is involved in motor functions. So walking, running, playing basketball, playing the piano. Anything that requires motor movement, it starts making connections at birth and it makes connections over the first year or two of life, and then pruning happens, but it's a rather steep curve. So pruning happens until about seven years of age. People who want their children to be really good at sports, let's say you have a dad who's a basketball player and he wants his child to be good at basketball, having the child play basketball when they're very little and they can make special pathways for shooting baskets, you can imagine I didn't play basketball while I was little, and I'm terrible at basketball. [ Laughter ] So if we wanted me to be better ‑‑ and I'm very short. I probably would have never been better at basketball. But I could have been better than I am, but nobody spent time with me when I was three and four years old and had me practice. And so practicing matters, practicing over and over again while a brain area is developing. Now, you already are experts on my favorite part of the brain, the prefrontal cortex. And that's right up here and it's a large area. It's this whole area of the brain. And it's developing ‑‑ remember, it's making connections for the first 10 to 12 years of life. It's pruning until about 25. So we're going to make some connections here so you start to get a sense of how this works. We use very sophisticated neuroscience material. [ Laughter ]. Yeah, yarn. Anyway, it's good to think about how would you get kids to do things? And if anybody has challenges, you have challenges. You're trying to teach children, and how you teach them is something you have to give a lot of consideration to. But all parents have to give consideration to how they teach. So let's say you want to teach a child to read, okay? If they are not visually impaired, then they're going to be using their eyes. Okay, so they're using visual circuits and then learning to look at words. Somebody is saying words to them. And they're making connections between the brain cells that are in this part of the brain and the brain cells that are in this part of the brain. Now, if you're talking about visual impairment they may learn through hearing or if you're visually and hearing impaired, they may learn through touch, but the parts of the brain that are being used are going to become connected to each other. What you have to do as a parent is how to make this really fun so that the child does it a lot of times. Because to build strong brain pathways you have to use a circuit over and over and over again. Lots of people ask, how many times do you have to use it? I would ‑‑ you know, it's different for different things, but I would roughly say thousands ‑‑ thousands with an s on it, thousands of times. Then you will make a really strong brain pathway. So doing an activity once a day, let's think, if the brain area is developing for the first five years of life and you're doing it once a day for 365 days a year, five times 365, you have a little under 2,000. Is that enough? No, probably not. Okay. So the challenge is how do you make it so fun for that child that they do what you want them to learn over and over and over again? So with reading how do you make it fun for a child? Well, usually you'll pick books that are about something the child's interested in. If you have a little guy that's interested in dinosaurs, you're not going to pick a book about fairy princesses, right? No. It would not be a hit. I can tell you, not a hit, okay? [ Laughter ]. With the little guy ‑‑ would the little guy want to read? No, he's not going to want to read. So what you do is you go find something that really matches exactly what that child is interested in. You direct all your activity to things they want to do. You'll teach them to read anything. Now, I had a really interesting experience this fall. I was explaining this and there was ‑‑ it was in Canada. In Canada the school system has a set curriculum and all children have to read the same books. And this woman out in the audience raised her hand ‑‑ you guys could raise your hand too. I like to interact with the audience. But she raised her hand and said, you know, Dr. Cameron, in Canada we have to read these books, and my daughter doesn't want to read them, so what I've done is I've taken all her books away and I've locked them up. And so the only books she has are the school books. And she got so mad at me, she refuses to read the school books. And if I'm understanding you correctly, you don't think I'm doing a good job, right? I said right! [ Laughter ]. That doesn't seem good. You want her to read! Give her back the books she wants to read. Think of some other way to get her to read the school books. But don't take all books away from her. And three weeks after I was there, I got a very cute post card from the little girl saying that her mom came home, took all of the books out of storage and she wondered what was going on. She said you need to thank Dr. Cameron. [ Laughter ]. She says you need those books back. And they're what you want to read and we should let you read them. So you want to remember that. It's hard as a parent to make things fun for each individual child. Every child is different. That is even more difficult. So you want to pay attention to what works for them, what they're interested in, and be tuned into that, because what you're hoping, and my dad would have a fit listening to me say this ‑‑ I mean you are hoping that they want to do this activity so many times that they will sneak a ‑‑ sneak a chance to go read. Right? I mean, we used to take the flashlights out of the basement at our house and sneak them into our bedrooms and pull the covers up over our heads and read by flashlight. My father would have a fit. He would ‑‑ if he caught us, he would say "This is bad for your eyes, you're not getting enough sleep." As an adult, I can say that is exactly what you should have let me do because I was reading over and over and over again and building strong brain pathways for reading. I think he probably wouldn't buy it, but you want to make things fun so children will read them. We're going to spend a little time in a few minutes talking about stress, but I want to give you an example. Because stress is very hard for people to wrap their heads around. And understand. And stress comes in many, many different forms. We don't all do the same thing. So let's look at an example here. Let's say we have a little child and he's growing up in the household, where somebody comes home at night and has trouble controlling their anger. They get angry, lots and lots of nights. Most children, when they are in that situation, will try to get out of the way. They don't want to be the target of that. So they'll go outside and play. Or they'll find something to do that will not be in the way of the person getting angry. What are they doing? Well, they're becoming experts on recognizing anger. Okay? So this part of the brain is getting activated. And it's learning to see what this anger looks like. And anger is complex. What does anger look like? Anger can be a loud voice, right? But not in everybody. Some people, when they get angry, they are very quiet. Quiet voice. Because they're getting angrier and angrier, so they are almost whispering. I mean, in a way I always feel like that's a more dangerous anger. So it's complex. Some people don't have modulation of their voice. They get red in the face. Some people don't do that. Some people go to a particular place in the house, maybe they sit in a chair and whenever they're there, it's just a matter of time until they're angry. So this child is having to pay attention to lots of different cues. They are having to pay attention to auditory cues, sensory cues, what's going on, different people get angry differently. But this child becomes an expert. And gets out of the way when anger looks like it's going to erupt. So this pathway, the pathway of recognizing anger and getting out of the way gets very used and very well developed. And it's going to be become stronger and stronger and stronger. Now, this is good. The brain is always the child's friend. It develops strong pathways for what the child is doing a lot. And this child will be able to recognize anger, get out of the way and that's going to be good because they're very unlikely to be the brunt of the anger, right? And that's protective. So the brain is protecting the child. Now, all of the rest of that child's life, they're going to have really strong pathways for recognizing anger. So a few minutes ago, I looked out and I said I saw a lot of people with their eyebrows down and kind of concentrating. And I thought that was good. But if I had grown up with a lot of anger, I would think quite a few of you were a little angry with me. Do you think I'm going to feel differently if I walk out the door and I think a third of you were angry? You're like enough of this poster stuff, get back to the slides! I'm sick and tired of posters. [ Laughter ]. I wouldn't feel very good about myself. If I leave here tonight and I think oh, you paid attention and you were interested, I'm going to feel good about myself. If I think a third of you were angry at me, I'm going to be pretty depressed. I'll be a little bit anxious about whether those guys at the back of the room are going to tell other people and then nobody will invite me to come talk again. [ Laughter ]. Yeah. No. My anxiety is going to go up. My depression is going to go up. What else happens? If every day of my life I interpret more people as being angry at me, I'm going to be more likely to have high blood pressure. And if my heart has been working that hard, I'm going to be more likely to have a heart attack. So by the time somebody is my age and in your 50s, 60s, your three times more likely to have a heart attack than if you didn't have those early life experiences. Life experiences make a big difference. I used to think heart attacks were your genetics. Then somebody said, "No, it's not all of your genetics." I said oh, right, if I go exercise, I eat a lot of ‑‑ if I don't exercise, eat a lot of fat food, that's the problem. What I'm telling you is early life experiences change your brain. You build different pathways, you see the world differently, and that has a threefold effect on your chance of having a heart attack. That's huge, right? So ... people who have adversity of that type, early, while brain pathways are forming, are going to be more likely to have anxiety, depression, to try to solve it with addictions, they're going to have cardiac problems. There's a whole host of problems. It's not that the brain was trying to work against you, though. That's why I spent a lot of time on this. The brain was trying to help you. The brain was keeping you safe. When you were little. So the brain always adapts to what you're dealing with as a child. And I think you would be able to use this information in thinking about what do your kids do? What do they spend a lot of time doing? How is that going to shape their lives through the rest of their lives? But remember I told you we're going to finish up, we're going to finish this little piece ‑‑ I'm not done yet, don't get excited. [ Laughter ]. But we're going to finish this little section with resilience, because we're going to talk about pathways that come from the prefrontal cortex. In your teenaged years and early 20s, this part of the brain is developing pathways and it connects to every other part of your brain. So hopefully the front part of your brain is starting to say, "Well, you should rethink how you're interpreting those faces out there. Do those people have any reason to be mad at you? No. They don't have a reason to be mad at you. They're just showing interest." This front part of your brain is complex thinking. It can reason through that. But remember, to build strong pathways, you have to use those circuits thousands of times. So you thought working with young kids was tough. Try making reasoning fun for a teenager. Right. That's what I just said. [ Laughter ]. Fun for a teenager. Yes, because they have to do it over and over and over again. Not only reasoning, but maybe problem solving, figuring out that everything they see isn't exactly what they think it is to start with, it may be something else. Or controlling what they do in certain circumstances, I mean, I very effectively learned that when I don't get my way, I shouldn't just lie down on the stage here and have a temper tantrum, right? I'm far too old for that and it's not appropriate in an audience like this. Right? [ Laughter ]. No. My prefrontal cortex did very, very well. According to my father that's what I would do and I would do it very effectively. But this part of the brain is controlling what I do. So you want to take advantage of that. It controls every other part of the brain and it is developing late and the things it is in charge of doing, problem solving, complex reasoning, inhibiting your actions, are all things that help children be resilience. Okay. We're going to move on to the second topic and I promise we're going to speed up here. In fact, the second topic is going to go pretty quickly because this ‑‑ I think, you are probably better experts on than I am. And what we're talking about is stable, caring relationships. And the fact that they're very, very important for children to do well. So adults, they care about children, introduce children to the world. The first picture over on the right shows a mother picking up a baby and looking at them. The baby learns the kinds of expressions that the mom smiles, when the mom is happy. That the mom's eyes looking at the baby are trying to get the baby's attention. You think oh, these things develop naturally, but they are learned. You have to have those interactions in order to do that. They introduce children to what the world is around them. How to do things in the world. And in the end, what we're all trying to do is get children to be able to do everything themselves and learn new things themselves. So I'm going to show you another video. And then we will use this other poster over here. swswsw instinctually serve through battling facial gestures, the adults return the serve responded in a very directive when a baby coos and the adult interacts and directs the baby's attention to a face or hand. The key to forming strong brain architecture is known as serve as return interaction with adults. In this developmental gainful, knew row natal connections occur in the brain as children instinctively learn in facial expressions and searches. And adults return the serve, responding in a very reactive, meaningful way. It starts very early in life when a baby coos and the adult interacts to the baby's interaction to a face or hand. This interaction forms the foundation of brain architecture upon which all future development will be built. It helps create neural connections between all the different areas of the brain, building the emotional and cognitive skills children need in life. For example, here's how it works for literacy and language skills: When the baby sees an object, the adult its name. This makes connections in the baby's brain between particular sounds and their corresponding objects. Later adults show young children that those objects and sounds can also be represented by marks on a page. With continued support from adults, children then learn how to decipher writing and eventually to write themselves. Each stage builds on what came before. Ensuring that children have adult caregivers who consistently engage in serve and return interaction, beginning in infancy, builds the foundation in the brain for all the learning, behavior and health that follow. Cameron: Okay. So a way to think about this that Working for Kids is using, is using a poster like this where we put a child right here in the middle and we've made a circle of learning. What does it take to learn anything? Well, the first thing it takes is it takes the child becoming interested in learning that. And that can be difficult, okay? Different children are different. They may not be interested in learning what you're trying to teach them, so you have to be very clever and get them to be interested, making use of things that they show an interest in. Once they're interested in learning something, they need to engage in the activity. It's not good enough just to watch an adult do something because they have to use their own neural circuit. You already know this. You've become experts over here, right? You have to use those circuits over and over again to strengthen them. So they have to do the activity. It's important for adults to think about this. When children start doing an activity for the first time or even for the 10th or 20th time, they usually aren't experts at it. They'll make lots of mistakes. It won't turn out so well. And lots of parents want to help out. They really care about their children. They want to help them, but that's not helping their brain develop. In order for their brain to develop well, the child needs to do it. So you have to show lots of compassion and lots of caring and lots of motivation and eagerness, even if they're doing things not so well because you're trying to encourage them to do that over and over and over again. And I think that can be really tough. Once they've engaged, you want them to develop self‑confidence so that they do it on their own and they don't need adults there all the time to do it. Now, it turns out that children are not in the little vacuum just learning new things, they live in the real world, okay? And in the real world there are a lot of things that we can provide that will encourage kids to learn. And what we do with this poster is have a conversation with the group that we're teaching about what are some of those attributes? What are some of the attitudes? What are some of the things that you can place in an environment that will help children learn? Well, usually one of the first things people talk about is love. If children are in an environment where they have love, then they feel more confident to try new things. If they have support from people around them, they're more likely to engage in learning. What I just talked about was that learning really requires the adults to have patience. This can be difficult, I know. Remember, I have three children. And we're still building brain pathways. [ Laughter ]. And it takes a lot of patience. Okay. Stability. Stability really works very well for children. They need to know that they can trust ‑‑ and I actually think I have trust here too. They can trust the adults that are around them to have a stable environment where they know what's going to happen and they feel safe and they can spend time learning things. So stability can be very important. They need to have their needs met and be taken care of. It's very hard, of course, to learn new things that are hard for you if you don't know whether you're going to get fed or not, you don't know whether you're going to have a place to sleep, so care matters and it matters a lot. I think these two things, motivation and encouragement, are really, really important. They're going to try to do new things, and everything they're trying to do is new for them. They're having to build brain pathways and it's hard, and they aren't as good at it as they want to be. They need encouragement and motivation. And if we have a child growing up in a situation where they're surrounded by these things, then they're very likely to learn lots. Even very difficult things, even if there is adversity, even if they were born with issues that they're going to have to cope with that make it more difficult, it will be doable because they're in an environment where adults are making it possible for them. On the other hand, there are other issues that go on. We talked here with this red circuit about a child growing up in a household where somebody got angry on a regular basis. Well, you can also live in a household where there's an adult that is mean, not nice, just doesn't really help the child and says mean things about the child. If they have all of these other things in their environment, they can usually deal with that. It isn't pleasant, but they're likely to learn a lot of things. And not be so adversely affected by it. But let's say there's one adult in their environment that's mean, but there's another one who's really depressed themselves and becomes quite detached. They just don't focus on the child. Well, if you have an adult that's detached, an adult that's mean, you probably are not feeling like you can trust the environment very much, right? And you're probably not feeling like somebody around you is all that patient. And so you can use these tools to talk to people. I don't usually stand up here and talk to an audience and introduce the concepts. I let the audience talk to me about what they're facing in their lives. And then we put up the words and think about what else could we do for the child. Now, what becomes really, really important? And I think that you will resonate with this, is that not everything that a child needs can come from the parent. The parents had a lot to do. They can't provide all of this and make sure that the child's not getting so many of these things. That's too much for anybody. We've been trying to think of a way to explain that, and recently we came up with the idea of charging stations. And it seems to be working pretty well. So many people have cell phones and they know they need to plug their cell phones in in order to charge them up so that they really function well. Well, people need charging stations also. All of us need to be plugged in to the resources in our community that can help us. And we want to think about what are the charging stations in our life? Maybe your sister or your mother is a charging station for you. She helps with the child, she makes you feel better. It's a very specific charging station, but you really need her. She's doing a lot of good. That would be a charging station. You might have big CHARGE ‑‑ charging stations that really provide a wide variety of services. Maybe the School for the Deaf and blind would be considered a bigger charging station that can help children and help the adults learn how to cope with things. Or maybe a conference like what you're here at today could be a charging station, you're meeting other people to talk to, you're hearing experts talk, you have resources that you can ask questions for. So we would think of that as serving many, many purposes. So when you're thinking about these issues, I think you want to think about what can you provide as a parent, as a caregiver? What do you want to try to minimize? And who else can you turn to? Don't try to do everything yourself. Make use of the resources around you. The child is the one that we care about and the child will do much, much better if we all make better uses of our charging stations, right? Since we've been working on that, I've really started to think about the charging stations in my life, and I'm not actively there mothering the children anymore. In fact, the small amount of mothering I do they think it's too much. [ Laughter ]. But I think they still need stability. I think they still need encouragement. I think that they still need love in a very big way. And some days I'm just overwhelmed, so I pay attention to my charging stations also. And I suggest that all of you think about this. It helps me. Okay. So we're going to turn now to a couple other things that working for kids tries to do a very good job at talking to people about. And we use a series of little figures, these little round faces, of the ‑‑ that were developed by the Fred Rogers center, Fred Rogers was a TV program in ‑‑ in the United States for over 30 years. Fred Rogers was a very kindly man. Who ran a children's TV show. And it was produced in Pittsburgh. And so the Fred Rogers center is in Pittsburgh. And they have developed little figures like this. That are simple interactions, simple ways of interacting with children that really make a difference. And they collaborate with working for kids. To try to get this message out. So connecting. When you see a child that's unhappy, many adults feel like they should just make them happy and be happy. But what does it feel like? If I'm feeling kind of glum and somebody walks in the room and says, "Hey you look a little droopy, cheer up for goodness sakes!" I feel like, huh, they don't understand me at all. That's not a good feeling and I don't cheer up. I actually get grumpier. [ Laughter ] well, children are just like adults in this way. They need to feel like people understand them. So if they don't look so happy, a more effective way is to try to connect with them. Say "I see you're not looking so happy. Why aren't you looking happy? What's wrong?" And try to understand how they're feeling. Yes, you would like to cheer them up. But try to understand where they are at to start with. Before you just forge forward with cheering them up. Another interaction that we've talked about both in the introduction and I've mentioned several times, is serve and return. Now, it comes as a surprise to some adults that the adults don't get to do the serving in this interaction. [ Laughter ]. That's not what this means. The adults are not serving to the children and then the children returning and doing just what the adult wants. At least very few children are like that. The child is serving. Showing what they are interested in. Showing what they want to do. Showing what they care about. And the adult is trying to figure out how to make use of that so that the child gets to learn and be ‑‑ learn everything that they need to learn. So the child is serving, the adult is returning, with one‑on‑one interactions. Another thing that you have to learn as the parent is that children need to progress. You spend a lot of time thinking about how to get them to take those first steps in learning something, but then they actually start doing it by themselves and what adults have to do is learn to step back. Right? And be supportive. But let the child progress on their own. They're not going to be able to function in the real world if they don't learn to progress on their own. And this can be very difficult for adults. You spent all of your time trying to be very interested, getting them to assess and to encourage and then as they start to be able to do things, what we're saying is you need to step back. You need to be there. And provide love and encouragement, support, but don't do it for them. Don't help them too much. Let them learn to progress on their own. So progression is very important. We'll talk a little bit about stress. You've already learned that the body deals with stress by forming some very specific circuits. The ‑‑ the take‑home messages in this slide are that stresses can be cumulative over time and you've already learned that they are embedded during critical periods. During the periods that the circuit is forming, and experiences matter, it's sensitive to stresses. It's why two children can experience the exact same stress, but if they're at a different point in brain development, the stress will have different effects. Because different parts of their brain are developing, so different parts are sensitive to the stress. What are the long‑term impacts of early stress? You've learned a little bit about this. And I just want to kind of let you know that the field of brain development and neuroscience has really made some strides here. We've talked about brain architecture and spent a lot of time talking about neural circuits. But every cell in the body has the genome in it. You're born, every single cell you have, has your DNA. It has a copy of the entire recipe for everything, every cell, all of your life. Every cell has that. Every cell does not use your whole genome all the time. I mean, with any luck, the cells in your liver are using the recipes for how to metabolize things. The cells in your GI tract are using the recipes for how to digest things. And neither one of them is trying to think complex thoughts, right? But you don't want your liver thinking complex thoughts. You would like your brain to think those complex thoughts. [ Laughter ]. So gene expression refers to which genes a cell is using. Okay? So all the genes are present in every cell, but gene expression said which ones are directing the activity of that cell? And one thing that stress can do, that we won't talk about a lot, but it's important for you to hear at least once, is stress can turn on genes and turn off genes and those can have permanent effects. So it isn't just that you have changed brain architecture, you've changed the recipes that are being used to govern your life. That's why stress can have a long‑term impact. Stress also leads to hormone secretion, so secretion of things like cortisol. Now, I get asked a lot about cortisol. Do you think because I secrete cortisol when I'm stressed that's bad for me. I said no, cortisol is really important. That door just opened over there and a very nice looking woman just walked in. But ... what if a bear had poked their head in? Yeah. [ Laughter ] that would be bad. I would see that and I would say, I'm out of here. I would run and go out that door. The rest of you, you're on your own. Okay? [ Laughter ]. But I saw the bear, what went up? Cortisol went up. What does it do. Mobilizes fuel, glucose from my liver, from my fat cells, it says here's some energy and get the heck out of here and I get the heck out of there, right. So cortisol expressed every day it can suppress the immune function and could be negative. But cortisol is not the main reason that stress is bad for you. Stress is associated with hormone changes. But that's not the main way that stress has an impact on your brain. Changes in pathway development, changes in gene expression are the main ways that stress has an impact on your brain. Then I told you and we talked about the fact that it can change the way you see the world and I wanted to show you this slide. Because this is a study done by a friend of mine, Seth Pollack at the university of Wisconsin, he's a child psychologist. What he did here was very clever. He had a number of adults and he took a picture of a man making a happy face here, and a man making a fearful face. And he fed those two pictures into his computer and he asked the computer to make all of the pictures in between. So all of these faces are made by the computer. The computer said I'll take 10% of the pixels, the little dots, from the happy face, I'll meet them with the fearful face. That's this right here. If I can use the arrow. If you took 20% happy it's here, 30% happy is here, 40%, 50%. The 50% place is where the computer has taken an equal number of pixels from each face. It's exactly where the expression changes halfway. We know it's exact because the computer actually very deliberately took exactly half. He then invited kids into his lab and he said ‑‑ he got rid of the numbers. He said pick out the place where this face changes from happy to fearful. Or angry to fearful. Or angry to sad. So we're going to look at the results. He brought in normally developing kids and he said, where does the face turn from angry to fearful? Or angry to sad? Well, kids and adults are really good at this. They picked exactly the 50% part. How about if he brought in kids that had grown up with somebody in their household who was angry? They said anger is there all the way to over here. It doesn't become fearful or sad until here. They became super good at detecting anger. And you guys already know why, right? You're officially neuroscientists now. And you know that a childlike that will have developed really strong brain pathways that they will have those for the rest of their life. Okay. We're going to see ‑‑ another little video. [Video] Learning to deal with stress is an important part of healthy development. When experiencing stress, the stress response system is activated. The body and brain go on alert. There's an adrenaline rush, increased heart rate and an increase in stress hormone levels. [Heart beating] when the stress is relieved after a short time or a young child receives support from caring adults, the stress response winds down and the body quickly returns to normal. [Heart beating]] in severe situations such as ongoing abuse and neglect where there is no parent to act as a buffer against the stress, the stress response stays activated. Even when there is no apparent physical harm, the extended response from adults can activate the stress response system. The constant activation of the stress response overloads developing systems, with serious life long consequences for the child. This is known as toxic stress. Over time, this results in a stress response system set permanently on high alert. In the areas of the brain dedicated to learning and reasoning, the neural connections that comprise brain architecture are weaker and fewer in number. Science shows that the prolonged activation of stress hormones in early childhood can actually reduce neural connections in these important areas of the brain and at just the time when they should be growing new ones. Toxic stress can be avoided if we ensure that the [indiscernible] in which children grow and develop are nurturing, stable and engaging. Cameron: So what we all care about is how can we prevent long‑term impacts of early life stress? Well, we have a conceptual framework. We think all of these really good skills that we're learning, parenting education, sound nutrition, stimulating experiences, and health‑promoting environment push the child upward and help them have a positive trajectory in life. However, if they're facing significant adversities and different adversities have different impacts, but you can have impaired health and development. What the field is working on right now is trying to put in place protective interventions. And part of why I'm here talking to you is because we're getting better with protective interventions. And education is a really important first step in that. So what we're trying to provide you with is educational tools that you can use to think about these and then use can become the innovators and you can think about new interventions that will be really helpful. Such interventions would prevent a downward trajectory when children face stresses because all children are going to face stresses at some point. Another way of thinking about this is to think about a balance, and you might think here's a child ‑‑ I'll stand here. Here's a child, okay. They're born and if we think about them as a balance, some good things happen to them and kind of tip them towards the positive side, and some bad things happen and tip them back a little bit more. And it's easy to think that, well, maybe it's just a balancing issue. If they've had to deal with more adversity, let's just pile some more good things on here and tip them right back. But what we have to remember is that children are born at different places, so the fulcrum is different in different children. Some children are very responsive to adversity, so a little bit of adversity tips them way towards adverse. Other children are very sensitive to positive things and it doesn't take much and they tip positive. So what we really want to understand is how can we change the fulcrum, right? We can't just go around piling more and more positive things on, and it's not practical and we don't know enough positive things. So what we want to know is how can we change the fulcrum here? How can we make children more resilient, easy to lean towards the positive. And that's where that prefrontal cortex comes in. The capabilities to manage stress and be more resilient are things like focusing attention, problem solving, planning ahead, behavior regulation, controlling impulses, adjusting to new circumstances, and every single one of those are controlled by that front part of the brain that develops until children are 25 years of age. So that's a very positive note to end on. It means that although they may have had an effective adversity and we showed that here by showing this red circuit, if we do a good job with the development of these more mature circuits that develop in adolescence, we can overcome the negative repercussions of that early life input. It won't get rid of it completely, but it can certainly make life a lot better. So as I said, we're spending a lot of time in communities trying to make sure children have stable, caring relationships. Trying to provide educational tools that will strengthen families. And then we'll have them make use of those charging stations, other relationships, other resources. We need to think with all of you, and I'm always on a mission to get everybody I talk to to think about this, and if you come up with really good ideas, email me, okay? You can go to the Working for Kids website, which is www.workingforkids.com, send an email because if you come up with an idea of how interventions can be provided earlier or how communities can get more involved, I would love to hear about it. We've developed a number of educational tools. You've seen them today. But I'll leave you with one last very short video. Worldwide in stressed communities there's a transition generational pipeline whereby children growing up in the community seemed doomed to become impoverished adults with low skill levels, barely able to eek out an existence. But it doesn't have to be this way. Working for Kids is a neuroscience based, hands on educational program designed to teach adults about how the brain develops and how experiences children have can actually shape the structure of the developing brain. The program was designed to be understood by adults from a variety of educational and cultural backgrounds. With Working for Kids training, communities can prepare children for school and support them so they become healthy, productive members of the community. Working for Kids has been developed to meet the needs of a number of professionals who work directly with children, including doctors and law enforcement. In addition to our current educational tools, we are developing online training courses for professionals, text messaging and other resources to best support our customers. Cameron: So we want you to make use of these things. It's been a real pleasure to talk to you. I'm really looking forward to the panel that you're going to have that helps translate this to the deaf and blind. And I'll be on that too. So see you, I think, in a half hour. Yeah. [Applause] [Silence] Fade up from black. Animation: Text for TSBVI transform into braille cells for TSBVI. Fade to black.